Individual provider Active NPI

Sarah Vincent

  • Addiction (Substance Use Disorder) Counselor
  • Bend, OR
National Provider Identifier
1063884955
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
920 SW Emkay Dr Ste 104
Bend, OR 97702-1043
Phone
(541) 383-0844
Fax
(541) 383-0840
NPI assigned
Oct 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

920 SW Emkay Dr Ste 104
Bend, OR 97702-1043

Mailing address

920 SW Emkay Dr Ste 104
Bend, OR 97702-1043
Phone (541) 383-0844

Other practice location 1

1333 NW 9th St
Prineville, OR 97754-1482
Phone (541) 447-2631

Other identifiers 1

IdentifierTypeStateIssuer
136460MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1063884955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 SW EMKAY DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021043",
            "telephone_number": "541-383-0844",
            "fax_number": "541-383-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 SW EMKAY DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021043",
            "telephone_number": "541-383-0844",
            "fax_number": "541-383-0840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 NW 9th St",
            "address_purpose": "LOCATION",
            "city": "Prineville",
            "state": "OR",
            "postal_code": "977541482",
            "country_code": "US",
            "telephone_number": "541-447-2631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136460",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.